PDF(Pubmed)
Abstract：
OBJECTIVE: To analyze the influence of individual and contextual factors of the hospital and the municipality of care on the survival of patients with Severe Acute Respiratory Syndrome due to COVID-19.
METHODS: Hospital cohort study with data from 159,948 adults and elderly with Severe Acute Respiratory Syndrome due to COVID-19 hospitalized from January 1 to December 31, 2022 and reported in the Influenza Epidemiological Surveillance Information System. The contextual variables were related to the structure, professionals and equipment of the hospital establishments and socioeconomic and health indicators of the municipalities. The outcome was hospital survival up to 90 days. Survival tree and Kaplan-Meier curves were used for survival analysis.
RESULTS: Hospital lethality was 30.4%. Elderly patients who underwent invasive mechanical ventilation and were hospitalized in cities with low tax collection rates had lower survival rates compared to other groups identified in the survival tree (p<0.001).
CONCLUSIONS: The study indicated the interaction of contextual factors with the individual ones, and it shows that hospital and municipal characteristics increase the risk of death, highlighting the attention to the organization, operation, and performance of the hospital network.
METHODS: Hospital cohort study with data from 159,948 adults and elderly with Severe Acute Respiratory Syndrome due to COVID-19 hospitalized from January 1 to December 31, 2022 and reported in the Influenza Epidemiological Surveillance Information System. The contextual variables were related to the structure, professionals and equipment of the hospital establishments and socioeconomic and health indicators of the municipalities. The outcome was hospital survival up to 90 days. Survival tree and Kaplan-Meier curves were used for survival analysis.
RESULTS: Hospital lethality was 30.4%. Elderly patients who underwent invasive mechanical ventilation and were hospitalized in cities with low tax collection rates had lower survival rates compared to other groups identified in the survival tree (p<0.001).
CONCLUSIONS: The study indicated the interaction of contextual factors with the individual ones, and it shows that hospital and municipal characteristics increase the risk of death, highlighting the attention to the organization, operation, and performance of the hospital network.
摘要：
目的：分析医院和护理城市的个体和背景因素对COVID-19导致的严重急性呼吸综合征患者生存的影响。
方法：医院队列研究，数据来自2022年1月1日至12月31日住院并在流感流行病学监测信息系统中报告的159,948名由于COVID-19而患有严重急性呼吸系统综合症的成年人和老年人。上下文变量与结构相关，医院设施的专业人员和设备以及市政当局的社会经济和卫生指标。结果是医院生存长达90天。存活树和Kaplan-Meier曲线用于存活分析。
结果：医院死亡率为30.4%。与生存树中确定的其他组相比，接受有创机械通气并在税收征收率低的城市住院的老年患者的生存率较低（p<0.001）。
结论：研究表明，情境因素与个体因素的相互作用，它表明医院和市政特征增加了死亡风险，强调对组织的关注，操作,和医院网络的性能。
方法：医院队列研究，数据来自2022年1月1日至12月31日住院并在流感流行病学监测信息系统中报告的159,948名由于COVID-19而患有严重急性呼吸系统综合症的成年人和老年人。上下文变量与结构相关，医院设施的专业人员和设备以及市政当局的社会经济和卫生指标。结果是医院生存长达90天。存活树和Kaplan-Meier曲线用于存活分析。
结果：医院死亡率为30.4%。与生存树中确定的其他组相比，接受有创机械通气并在税收征收率低的城市住院的老年患者的生存率较低（p<0.001）。
结论：研究表明，情境因素与个体因素的相互作用，它表明医院和市政特征增加了死亡风险，强调对组织的关注，操作,和医院网络的性能。
